The posttransplant care outlined in Core H supports intensive ambulatory treatment before and after allogeneic transplant for all patients treated according to protocols presented in all projects of this Program Project. This Core also provides assistance to referring physicians in long-term posttransplant management of pediatric transplant patients. The major objectives are (1) to improve ambulatory care of the allogeneic transplant recipient in the outpatient department in the center and in the home community, and (2) to improve the long-term quality of life for children after marrow transplantation. The first objective evaluates discharge home at day 60 (early discharge) of medically stable ambulatory patients to determine the outcome for patients treated at the transplant center and in the home community. Data regarding hospitalizations and health care utilization will be utilized to design ways to assist community providers in the care of posttransplant allogeneic recipients. For the second objective, improvements in long-term quality of life of children after transplant, a number of studies will be conducted including: (a) studies to improve the final adult height of children through early administration of growth hormone and/or sex hormone, (b) a longitudinal study of neuropsychological function and time of appearance of learning disabilities among children receiving different preparative regimens, (c) a study of the incidence and progression of pulmonary disease among children surviving greater than or equal to 5 years after transplant, and (d) a study of the quality of survival of adult survivors of a childhood marrow transplant to evaluate whether these individuals are comparable with adult survivors of an adult transplant. The goal of Core H is to improve posttransplant survival and quality of care of children through early diagnostic and interventive strategies.